Carbapenem resistance in a rural part of southern India

Sekar, Ramalingam; Srivani, Seetharaman; Amudhan, Murugesan; Mythreyee, Manoharan

doi:10.4103/ijmr.ijmr_1035_15

Cited by 24 publications

(21 citation statements)

References 9 publications

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“…One study from rural southern India reported 22.1% of CRE in isolates from hospitalized children with blood stream infections, 13 while another study from the same rural population on hospitalized patients reported a prevalence of carbapenemase-producing E. coli and K. pneumoniae among all categories of infections, i.e.,19.4%. 6 However, in the later study, resistance to ertapenem was detected by disc diffusion method only in contrast to our study where detection rate of CRE was based on positivity by both MHT and MIC. Nevertheless, these reports indicate substantial evidence of CRE in rural community.…”

Section: Discussioncontrasting

confidence: 39%

“…4 In India, most of the reports of CRE among clinical isolates, especially harboring bla NDM-1 , are confined to patients attending hospitals in metropolitan cities 5 with hardly any report from population attending hospitals in rural area. 6 The present study was carried out to determine the prevalence of CRE and NDM-1 among E. coli and K. pneumoniae isolated from various clinical specimens in a multispecialty hospital catering to rural community in North India.…”

Section: Introductionmentioning

confidence: 99%

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Carbapenemase and NDM-1 Production by Escherichia coli and Klebsiella pneumoniae from Patients belonging to a Rural Community in North India Hospitalized with CommunityAcquired Infections

Chattopadhya¹

2018

JCD

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Carbapenem-resistant Enterobacteriaceae, especially New Delhi metallo-β-lactamase type-1-producing strains, exhibit multidrug resistance, thus posing a serious public health threat for treatment of infections caused by Gram-negative bacteria. However, most of the studies on the problem have been confined to hospitalized patients from urban population. The present study was carried out to detect carbapenemase production among Escherichia coli and Klebsiella pneumoniae Isolated from rural population hospitalized with community acquired infections. A total of 296 non-repetitive isolates of E. coli and K. pneumoniae were subjected to Modified Hodge test for carbapenemase detection, Metallo-β-lactamase detection by MIC test strip MBL and molecular detection of bla NDM gene by Polymerase Chain Reaction (PCR). Twenty three (7.8%) of the 296 isolates were detected as carbapenemase producers, of which five (21.7%) were found to harbor bla NDM genes by PCR. Gene sequencing of all the five isolates revealed bla NDM-1 genes. The present study showed the prevalence of carbapenemase-producing E. coli and K. pneumoniae in the rural community of North India and spread of NDM-1.

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Section: Discussioncontrasting

confidence: 39%

Section: Introductionmentioning

confidence: 99%

Carbapenemase and NDM-1 Production by Escherichia coli and Klebsiella pneumoniae from Patients belonging to a Rural Community in North India Hospitalized with CommunityAcquired Infections

Chattopadhya¹

2018

JCD

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“…According to one estimate, first-line antibiotic-resistant pathogens account for 25,692 neonatal deaths annually in Pakistan [ 45 ]. Resistance to carbapenems has been significantly observed in Asian countries, including Pakistan [ 30 , 46 , 47 ]. At present, numerous reports of MBL producers and ESBL producers from Pakistan present clinical catastrophes and alarming health issues [ 41 , 48 , 49 ].…”

Section: Discussionmentioning

confidence: 99%

High frequency and molecular epidemiology of metallo-β-lactamase-producing gram-negative bacilli in a tertiary care hospital in Lahore, Pakistan

Ain

Iftikhar

Bukhari

et al. 2018

Antimicrob Resist Infect Control

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BackgroundMetallo-β-lactamase (MBL)-producing isolates have a strong impact on diagnostic and therapeutic decisions. A high frequency of MBL-producing gram-negative bacilli has been reported worldwide. The current study was based on determining the incidence of MBL-producing imipenem-resistant clinical isolates and investigating the β-lactamase gene variants in strains conferring resistance to a carbapenem drug (imipenem).MethodsA total of 924 gram negative isolates were recovered from a tertiary care hospital in Lahore, Pakistan, during a two-year period (July 2015 to February 2017). The initial selection of bacterial isolates was based on antibiotic susceptibility testing. Strains resistant to imipenem were processed for the molecular screening of β-lactamase genes. Statistical analysis for risk factor determination was based on age, gender, clinical specimen and type of infection.ResultsThe rate of imipenem resistance was calculated to be 56.51%. Among the 142 strains processed, the phenotypic tests revealed that the incidence of MBLs was 63.38% and 86.61% based on the combination disc test and the modified Hodge test, respectively. The frequencies of blaTEM, blaSHV, blaOXA, blaIMP-1, and blaVIM genes were calculated to be 46%, 34%, 24%, 12.5% and 7%, respectively. The co-expression of blaMBL (blaIMP and blaVIM) and blaESBL (blaTEM, blaSHV, blaOXA) was also detected through multiplex and singleplex PCR. blaOXA, blaTEM and blaSHV coexisted in 82% of the isolates. Co-expression of ESBL and MBL genes was found in 7% of the isolates.ConclusionTo our knowledge, this is the first report from Pakistan presenting the concomitant expression of blaOXA, blaTEM and blaSHV with blaIMP-1 and blaVIM in MBL-producing gram-negative bacilli.

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“…A pilot study conducted for a period of 1 year (January–December 2015) by the present laboratory reported lower prevalence of carbapenemase-producing E. coli and K. pneumoniae , i.e., 7.8%[ 9 ] compared to studies from rural Southern India reporting 19.4%–22.1% carbapenemase production among similar isolates. [ 31 32 ] In the present study, the sequence analysis of 12 bla NDM harboring isolates was found to be all positive for bla NDM-1 variety, while studies conducted in urban cities, namely Delhi and Aligarh, Uttar Pradesh, India, reported other variants of bla NDM among E. coli isolates, i.e., bla NDM-4 , bla NDM-5 , bla NDM-7 , and bla NDM-8 . [ 15 33 ] There is hardly any report of bla NDM-1 detection in CAI patients from rural community from India.…”

Section: Discussionmentioning

confidence: 48%

Increasing prevalence of Escherichia coli and Klebsiella pneumoniae producing CTX-M-type extended-spectrum beta-lactamase, carbapenemase, and NDM-1 in patients from a rural community with community acquired infections: A 3-year study

Devi

Broor

Rautela

et al. 2020

Int J App Basic Med Res

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Carbapenem resistance in a rural part of southern India

Cited by 24 publications

References 9 publications

Carbapenemase and NDM-1 Production by Escherichia coli and Klebsiella pneumoniae from Patients belonging to a Rural Community in North India Hospitalized with CommunityAcquired Infections

Carbapenemase and NDM-1 Production by Escherichia coli and Klebsiella pneumoniae from Patients belonging to a Rural Community in North India Hospitalized with CommunityAcquired Infections

High frequency and molecular epidemiology of metallo-β-lactamase-producing gram-negative bacilli in a tertiary care hospital in Lahore, Pakistan

Increasing prevalence of Escherichia coli and Klebsiella pneumoniae producing CTX-M-type extended-spectrum beta-lactamase, carbapenemase, and NDM-1 in patients from a rural community with community acquired infections: A 3-year study

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